Atopic dermatitis or hyper-IgE syndrome?

Abstract

A case of atopic dermatitis (AD), recurrent infections, and elevated immunoglobulin E (IgE) level is presented. Clinical characteristics, pathophysiology, diagnosis, and management in this patient are reviewed. Clinical pearls and pitfalls include the following: (1) deep-seeded Staphylococcus aureus infections occur rarely in AD and should raise the possibility of immunodeficiency syndromes such as hyper-IgE syndrome (HIES); (2) HIES is characterized by a clinical triad consisting of elevated serum IgE levels, recurrent staphylococcal skin abscesses, and pneumonia with pneumatocele formation; (3) although serum IgE levels in AD have been noted to be as high as 10,000 IU/mL, severe cases of AD such as that presented here can exceed this range; (4) the efficacy of anti-IgE therapy in AD or HIES is unknown and may be limited by dosing requirements.

• Authors: Nkiruka U Ohameje, James W Loveless, Sarbjit S Saini
• Journal: Allergy and asthma proceedings (Allergy Asthma Proc) 2006 May-Jun Vol. 27 Issue 3 Pg. 289-91 ISSN: 1088-5412 [Print] United States
• PMID: 16913276 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antibodies, Anti-Idiotypic
• Antibodies, Monoclonal
• Antibodies, Monoclonal, Humanized
• Immunologic Factors
• Omalizumab

Topics

• Antibodies, Anti-Idiotypic
• Antibodies, Monoclonal (therapeutic use)
• Antibodies, Monoclonal, Humanized
• Child
• Dermatitis, Atopic (diagnosis, drug therapy)
• Diagnosis, Differential
• Humans
• Immunologic Factors (therapeutic use)
• Job Syndrome (diagnosis, drug therapy)
• Male
• Omalizumab